Abstract P655: Childhood and Lifecourse Socioeconomic Position and Cardiovascular Health in Hispanic/Latino Adults of the Hispanic Community Health Study/Study of Latinos
Authors: Paola Filigrana, Jee-Young Moon, Linda C Gallo, Lindsay Fernández-Rhodes, Krista M Perreira, Martha L Daviglus, Bharat Thyagarajan, Olga L Garcia, Jianwen Cai, Robert C Kaplan, Shakira F Suglia, Carmen R Isasi
Journal: Circulation (2023)

Introduction: The Hispanic/Latino population experiences extensive socioeconomic adversity across the lifespan. Yet little is known about the role of lifecourse socioeconomic position (SEP) on cardiovascular health (CVH) in this population. Hypothesis: Childhood and adulthood SEP as well as socioeconomic mobility are associated with changes in CVH over time in Hispanic/Latino adults. Methods: We used longitudinal data (N = 14,604) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based cohort study conducted in four major U.S cities. We determined childhood SEP using participant-reported parental education classified as No schooling; Elementary, middle, or high school; and more than high school (HS). Adulthood SEP was determined through an index with a score ranging from 0 to 9 combining participants’ education, occupation, annual household income, and assets, and classified as low (0), middle (1-4), and high SEP (5-9). Using childhood and adulthood SEP, we classified participants into socioeconomic mobility categories (e.g., persisting low, downward, or upward mobility, etc.). Using the four-health metrics of the American Heart Association “Life’s Essential 8” (i.e., body mass index, non-HDL cholesterol, fasting blood glucose or HbA1c, and blood pressure) we built a score of ideal CVH ranging from 0 to 100. CVH was assessed at baseline and at the 6-year follow-up. Since changes in CVH over time differed by CVH at baseline, we conducted linear mixed effects models stratifying by CVH at baseline, with random intercept and slope, adjusting for age, sex, Hispanic/Latino background, study center, U.S or foreign-born, years in the U.S, as well as baseline health insurance, diet, physical activity, hours of sleep per night, smoking, alcohol consumption, and antihypertensive and cholesterol medication use. Results: 8% of parents did not have any formal education, 11% of the population had low SEP in adulthood, and 37% showed upward socioeconomic mobility. Among those with low (CVH score &lt;50) and moderate to high (CVH score 50-100) baseline CVH, there was no association between childhood SEP and CVH at baseline. However, among those with moderate to high baseline CVH, high childhood SEP was associated with greater CVH over time (Coefficient for &gt;HS: 0.24, 95% CI: 0.00, 0.47). There was no longitudinal association among those with low baseline CVH. High adulthood SEP was associated with greater CVH at baseline for those with low (Coefficient: 2.55 95% CI: 1.25, 3.85) and moderate to high CVH (Coefficient: 1.36 95% CI: 0.09, 2.62). However, it was not associated with changes in CVH. Socioeconomic mobility was associated with greater baseline CVH as well as with improvements in CVH over time. Conclusion: Among Hispanic/Latino population with high initial CVH, high childhood SEP and socioeconomic mobility were associated with better CVH over time.